• Journal of Chest Surgery
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• v.19 no.2
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• pp.197-208
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• 1986

Propranolol is one of clinically useful antiarrhythmic agents and electrophysiologically classified as group II. And the negative inotropic effect which is not related to adrenolytic effect has been demonstrated with high concentration of propranolol. On the other hand, it has been well known that the calcium plays a central role in excitation-contraction coupling process of myocardium and also in electrophysiological changes of cell membrane. Author studies the effect of propranolol on calcium uptake and release in sarcoplasmic reticulum and mitochondria prepared from porcine myocardium to investigate the mechanism of action of propranolol on myocardium. The results are summarized as follow: 1] The maximum Ca++-uptake of sarcoplasmic reticulum is inhibited by propranolol in a dose dependent manner. 2] The release of calcium from sarcoplasmic reticulum is not affected by propranolol but with higher than 1x10-3 M of propranolol, rate of calcium release from sarcoplasmic reticulum is decreased. 3] Propranolol inhibits the maximum uptake and uptake rate of calcium in mitochondria non-competitively. [Ki = 6.21 x 10-4 M] 4] The rate of Na+ induced calcium release from mitochondrion shows a function of [Na+]2 and is inhibited by propranolol with the concentration significantly lower than that affect the calcium uptake in sarcoplasmic reticulum and in mitochondria [Ki = 2.91 x 10-5 M]. These results suggest that propranolol affects the intracellular calcium homeostasis which may considered to be one of the mechanism of action of propranolol on myocardium.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.147-148
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• 2010

Introduction: A metastatic calcification is known for taking in bone scintigram medicine at metastatic calcification lesion due to abnormal distribution of the calcium and phosphorus. The one paper reports that a metastatic calcification occurs mainly at lung, stomach, kidney and myocardium. Index: The patient is seventy four years old man who is afflicted with clonic kidney disease, hypercalcemia, hypertension. Because of an ability of the multiple myeloma, we take a bone scan after intravenous injection $^{99m}Tc$-DPD 25 mCi in three hours. We found out homogeneous $^{99m}Tc$-DPD uptake at both lung and myocardium. Conclusions: Nothing unusual was found in other bone scan. We obtains a purity beyond 95 percent at $^{99m}Tc$-DPD vial. In spite of no evidence about a myocardial infarction, the patient has a $^{99m}Tc$-DPD uptake at both lung and myocardium.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.260-263
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• 2000

A uremic patient on hemodialysis, who had concurrent cardiomyopathy showed intense myocardial uptake of $^{99m}Tc$-methylene diphosphonate (MDP). The presumed cause of uptake in the myocardium is metastatic calcification due to hypercalcemia secondary to the renal failure. However, supplementary mechanism caused by cardiomyopathy should be considered. We describe a case with bone tracer uptake in the myocardium in the absence of infarction in a patient with chronic renal failure.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.6
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• pp.519-525
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• 2009

Purpose: F-18 fluorodeoxyglucose (FDG) uptake of myocardium is influenced by various factors. Increased glycolysis, and subsequent increased F-18 FDG uptake has been reported in ischemic cardiomyopathy. However, clinical significance of incidentally found myocardial F-18 FDG uptake has not been clarified. We retrospectively reviewed the degree and pattern of myocardial uptake in patients without history of ischemic heart disease who underwent torso F-18 FDG PET/CT for evaluation of neoplastic disease. Materials and Methods: From January 2005 to June 2009, 77 patients who underwent F-18 FDG PET/CT and Tc-99m sestamibi stress/rest SPECT within 3 months were enrolled. Results: Of 77 patients, 55 (71.4%) showed increased F-18 FDG uptake in the myocardium. In this population, 40 showed uniform uptake pattern, while 15 showed focal uptake. In patients with uniform uptake, 17 showed decreased uptake in the septum without perfusion defect on myocardial SPECT. Remaining 23 patients showed uniform uptake, with 1 reversible perfusion defect and 1 fixed perfusion defect. In 15 patients with focal uptake, 9 showed increased F-18 FDG uptake in the base, and only 1 of them showed reversible perfusion defect on myocardial SPECT. In the remaining 6 focal uptake group, 4 had reversible perfusion defect in the corresponding wall, and 1 had apical hypertrophy. Conclusion: We demonstrated that septal defect pattern and basal uptake pattern in the myocardium may represent normal variants. Focal myocardial uptake other than normal variants on oncologic torso F-18 FDG PET/CT with routine fasting protocol may suggest ischemic heart disease, thus further evaluation is warranted.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.274-279
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• 1992

Clinical role of $^{99m}Tc-MIBI$ myocardial scintigraphy in the diagnosis of coronary artery disease (CAD) is now well accepted, however, the role of it in the identification of viable myocardium in patients with chronic CAD has not yet been clarified. To determine the usefulness of rest-injected $^{99m}Tc-MIBI$ scan as a marker of myocardial viability, the regional uptake of this agent at rest was compared with that of $^{201}Tl$ on reinjection and 24 hours after reinjection images. Subject patients were 13 chronic CAD patients who showed irreversible perfusion defect(s) on standard pharmacologic (dipyridamole) stress-redistribution images. Immediately after the redistribution images were obtained, 37 MBq thallium was injected at rest, and images were reacquired at 10 minutes and 24 hours after reinjection. After then 740 MBq $^{99m}Tc-MIBI$ was injected, and 1 hour later rest MIBI myocardial imaging was performed. Five sets of imagestress, redistribution, reinjection, delayed images of thallium, and rest image of MIBI) were then analyzed qualitatively and quantitatively. Left ventricle was arbitrarily divided into 9 segments (apex, basal and apical portions of anterior, septal, inferior, and lateral walls). Seven patients and 30 regions showed a fixed perfusion defect on the stress-redistribution images. Among 30 regions, 15 showed positive uptakes and 6 showed negative uptakes on both $^{201}Tl$ reinjection/delayed images and $^{99m}Tc-MIBI$ rest images. Five regions showed only thallium uptake and were regarded as viable clinically. Of four regions which showed only $^{99m}Tc-MIBI$ uptake, two were regarded as viable, while the other two were regarded as a nonviable scar tissue clinically. In conclusion, $^{201}Tl$ reinjection technique was more reliable in the identification of viable myocardium. However, the role of $^{99m}Tc-MIBI$ in identification of viable myocardium was still remained to be clarified because 2 of 9 regions showed only $^{99m}Tc-MIBI$ uptake and were regarded as viable tissues.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.6
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• pp.478-481
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• 2008

Reverse redistribution is frequently observed after revascularization in acute myocardial infarction, and usually regarded as a predictor of viable myocardium on stress/rest and 2- to 4-hour redistribution $^{201}Tl$ SPECT. However, there is not enough report of reverse redistribution in case of 24-hour delayed SPECT, which is commonly used for viability assessment. In this report, a case of reverse redistribution on rest and 24-hour delayed $^{201}Tl$ SPECT is reported with use of automatic segmental quantitative analysis. The myocardium of reverse redistribution was dysfunctional on gated SPECT, and diagnosed as non-viable on $^{18}F-FDG$ PET.

• The Korean Journal of Nuclear Medicine
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• v.35 no.6
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• pp.398-400
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• 2001

The authors report a case of unsuspected myocardial ischemia detected during CoDe FDG PET (coincidence detection fluorodeoxyglucose positron emission tomogram) which was performed for the evaluation of a solitary pulmonary nodule. Camera-based FDG PET without attenuation correction often reveals false defect in the inferior wall of the left ventricle in normals due to excessive attenuation. However, this asymptomatic patient had increased uptake in the inferior wall suggesting ischemic myocardium. The scan finding was confirmed by Tl-201 myocardial SPECT and coronary angiogram. The patient then underwent successful PTCA of mild RCA and right ventricular branch followed by right upper lobectomy for small cell lung cancer.

• Progress in Medical Physics
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• v.22 no.4
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• pp.172-177
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• 2011

The purpose of this study was to analyze $^{68}Ga$-BAPEN dynamic PET image in rat myocardium to evaluate potential of this radiotracer as a perfusion imaging agent. Animal PET/CT scan was done in 9 rats during 120 minutes. Especially we synthesized $^{68}Ga$-BAPEN with kit which is simple and low cost method. PET images showed the in vivo dynamic distribution of $^{68}Ga$-BAPEN in the chest region of rats. Initially $^{68}Ga$-BAPEN PET images showed aorta and liver activities and a few minutes later, $^{68}Ga$-BAPEN moved to myocardium. Regions of interest were drawn on myocardium, liver, lung and blood pool. Time-activity curves showed significant uptake of $^{68}Ga$-BAPEN in myocardium. The contrast ratios of myocardial to blood pool, lung and liver at 60 minutes after injection were 1.66, 2.82 and 0.60. To estimate accurate kinetic parameters, 60 minutes after injection was required to PET scan as myocardium image contrast ratios reached to constant values. As a result, $^{68}Ga$-BAPEN would be suitable radiotracer for PET which can applied to diagnosis of myocardial perfusion diseases after further preclinical and clinical investigations.

• The Korean Journal of Nuclear Medicine
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• v.25 no.2
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• pp.177-185
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• 1991

Dipyridamole thallium imaging is one of the most widely accepted means of evaluating patients with suspected or known coronay artery disease. The results of thallium imaging help diagnose coronary artery disesse (CAD), determine the hemodynamic significance of coronary stenosis, evaluate viability of myocardium, assess the outcome of therapeutic interventions and stratify patients according to their risk for luther cardiac events. An increased lung thallium uptake and transient LV dilation has been reported as poor prognostic indicator and associated with extensive and severe coronary artery disease. We quantitated lung/heart uptake ratio (l/HUR) and transient left ventricular dilation ratio in 44 patients and 17 controls undertaking dipyridamole thallium-201 scintigraphy. The results are as follows: 1) The lung/heart uptake ratio was high in patients with CAD and which became higher according to increasing number of diseased vessel. The L/HUR of patients with low LVEF (<35%) was lower than those with normal LVEF. 2) Transient left ventricular dilation ratio of CAD patients had no close relation between numbers of diseased vessels and was not higher than normals. But transient left ventricular dilation ratio of patients with myocardial infartion was higher than normals. We concluded that lung/heart uptake ratio seems to be sensitive marker for severity of CAD and myocardial function, but transient left ventricular dilation ratio alone is not sufficient to be a marker for severe and extensive CAD.

• The Korean Journal of Pharmacology
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• v.10 no.1 s.15
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• pp.55-59
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• 1974

Further elucidation of the mechanism of halothane's negative inotropic action has resulted from a study of the effect of various substrates on halothane-depressed rat atria. Approximately 6 mg% halothane was required to maintain a 50% depression of the contractility of rat atria suspended in a modified Krebs-Ringer bicarbonate glucose medium, pH 7.4, $30^{\circ}C$ for 2hr. Both lactate and acetate were found to restore partially the contractility of halothane-depressed atria. The maximally effective concentration of lactate was 5 mM; for acetate it was 2.5mM. Neither 5 nor 20 mM of additional glucose was effective in restoring the force of contraction of halothane-depressed atria. The results are consistent with the hypothesis that halothane exerts at least a part of its negative inotropic effect on rat atria by inhibiting either the uptake or utilization of glucose by the myocardium. The site of blockade must be prior to the conversion of pyruvate to acetyl CoA. In our previous report dealing with the mechanism of cardiac depressant action of inhalation anesthetic halothane, it has been demonstrated that: 1) approximately 6 mg/100 ml halothane is required to maintain 50% depression of the force of contraction of isolated rat atria in Krebs-Ringer bicarbonate glucose medium; 2) pyruvate partially restores the contractility of halothane-depressed atria, but has no effect on normal atria; the partial recovery of depressed atria by the addition of sodium pyruvate is due to the effect of the pyruvate ion itself, not to the sodium ion; 4) addition of pyruvate, to atria depressed with hypertonic medium, produced only further depression. From these findings we concluded that the cardiac depressant action of halothane on rat atria is a manifestation of inhibition of glucose uptake or utilization. The present studies were undertaken to observe the effect of other substrates on halothane-depressed atria in order to substantiate our conclusion. As with the case of pyruvate, lactate and acetate also partially restored the force of contraction of halothane-depressed atria. These data are consistent with the hypothesis that halothane inhibits glucose uptake or utilization in the glycolytic cycle of the myocardium.